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HomeMy WebLinkAboutHomestead_Lamon (2)FORM RIC 10 1979 To Be Filed in Duplicate Prescribed By State Board of Tax Commissioners CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 �9 /] P SEE BACK FOR FILING INSTRUCTIONS ©I (o — OQ (oa 9- O O �✓� " ' t 9), GU • /1LQh d ABC `x"`J certify that on the 1st day of arch, 19.1' 9— I, (We) occupied as our pr' cipal place of residence the following described real property for which a Homestead Property Tax Credit is hereby being claimed: I, .(We) ❑ owned ❑ are buying under contract ❑ have a beneficial inter st in the taxpayer Property Description in t, County Township Taxing District (City, Town, Township): Parcel Number If buying on contract: Owners or legal description shbWn on tax statement: �v '� �h (Z- <I- e 1'tj� 44V 41 x• Contract recorded in Recorders Office - Record If any portion of the residential structure or the land, not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion of the property utilized to produce income Any other counties in which individual owns or is buying real property: hereby certify the above statement is true, correct and complete. County Township Individual either owns or is buying under a contract that provides he is to pay the property taxes on the residence, or has a beneficial interest in the taxpayer. - FOR ASSESSOR'S USE ONLY Land not exceeding 1 ( a reTm_me�eDl surrounding residential i ro Other Land 11)M 1 5919 Total Land ,'off —�, Residential Improvements% � ° "elling �� AUDITOR 1/ Garage Total Other Improvements Tn Improvements - Line (6) plus (7) equals (8) ,._..,by certify the aboveA is true. correct,. and complete. Signature of Assessor Approved (2) (3) (4) (5) (6) (7) (8) True Cash Value —0— Assessed Valuation —O— Homestead Valuation -45--179 Dale Date: —� /�